Portelet House Care Home

We found the following examples of good practice.

People told us they happy and felt safe living at Portelet House Care Home. A relative told us, “The staff are angels and they will do whatever we need, always over and above.” The manager and staff at the home had worked hard to keep people safe. Policies and procedures within the home were robust and frequent monitoring meant that the home worked safely and within good practice and government guidelines. Staff appreciation was important to the manager and they told us they worked hard to ensure staff knew how important they were.

Safe practices were in place for welcoming visitors to the home. These included rapid COVID-19 testing, temperature checks. personal protective equipment (PPE) and hand hygiene. Vaccination status was checked for all visiting professionals. Records of mandatory staff vaccinations were maintained. Staff testing for COVID-19 was at the frequency in line with government guidance. All necessary consent was in place which included capacity assessments and specific risk assessments where appropriate.

Supplies of PPE were in good supply, stock checks maintained, and we observed staff wearing this correctly. Staff had training in infection prevention and control and were shown how to put on and take off PPE correctly. The home was a good standard of cleanliness and there was an ongoing programme of refurbishment and redecoration in place. Contingency plans in place meant that the home could operate under pressures such as an outbreak or staff shortages. Domestic staff worked to keep all areas of the home clean and tidy including deep cleaning.

People were supported to maintain vital contact with their loved ones during the COVID-19 pandemic. Visiting restrictions changed and the home adapted its policies, practices and communicated to people and their relatives verbally and by telephone. Risk assessments were completed for all aspects of care and support including additional risks related to COVID-19. The manager told us they had a good working relationship with external health and medical practitioners, this included regular checks of the health needs for people living at Portelet House Care Home.

Portelet House Care Home was registered for 15 people. There were 14 older people living in the home at the time of our inspection. The home is an adapted building in a residential area of Bournemouth. People had a variety of care and support needs related to their physical and mental health. The majority of people living in the home had needs associated with dementia.

This unannounced inspection took place on 26 January 2019.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good. There was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Why the service is rated good.

People continued to receive a service that was safe. The registered manager and staff understood their role and responsibilities to keep people safe from harm. Risks were assessed and plans put in place to keep people safe. There were enough staff to safely provide care and support to people. Checks were carried out on staff before they started work to assess their suitability to support vulnerable people. Medicines were mostly well managed and people received their medicines as prescribed. Information about when to give some medicines was checked and recorded following our visit. The home was clean and staff followed the providers infection control policy and procedures.

The service remained effective in meeting people’s needs. People were cared for by staff who felt supported and had access to effective training. People had access to healthcare professionals for both ongoing and emergency treatments. The manager and staff worked to ensure people's rights were respected. People were supported to enjoy a healthy and varied diet. The environment had been decorated to reflect the needs of people living in the home.

The service continues to be caring. Staff were motivated to provide a caring service to people. They spoke warmly of people and worked in ways that respected and promoted their dignity.

The service was responsive to people’s needs. People’s preferences were evident in their care plans and the staff understood how they communicated their wishes and emotions. Changes in people’s needs were quickly identified and their care was amended accordingly. People and their relatives felt able to make requests, raise concerns and express their views. They felt listened to by care staff and the management team. We have made a recommendation about the recording of discussions with people about their end of life wishes.

The service continues to be well led. Staff understood their roles and shared the vision of ensuring a homely environment where people received personalised care. The manager had applied to be registered with the Care Quality Commission and demonstrated their commitment to ensuring positive outcomes for people and staff and improving the quality of people’s experience. There were processes in place to monitor quality and understand the experiences of people who used the service.

Portelet House provides accommodation and personal care for up to 15 older people in a small, homely environment. At the time of the inspection there were 13 people living at the home.

There was no registered manager at the home at the time of the inspection. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. The last registered manager ceased working at the home in September 2015. A new manager has been appointed to manage Portelet House and has applied to register as manager.

Overall, we found people were being well cared for and supported at Portelet House.

The home was well managed with established monitoring and auditing systems to make sure that the environment and way people were looked after were safe. Risk assessments had been completed to make sure that care was delivered safely with action taken to minimise identified hazards. The premises had also been risk assessed to make that the environment was safe for people.

Staff had been trained in safeguarding adults and were knowledgeable about the types of abuse and how take action if they had concerns.

Accidents and incidents were monitored to look for any trends where action could be taken to reduce chance of their recurrence.

Sufficient staff were employed at the home to meet the needs of people accommodated.

There were recruitment systems in place to make sure that suitable, qualified staff were employed at the home.

Medicines were managed safely.

The staff team were both knowledgeable and suitably trained.

There were good communication systems in place to make sure that staff were kept up to date with any changes in people’s routines or care requirements.

Staff were well supported through supervision sessions with a line manager, and an annual performance review.

Staff and the manager were aware of the requirements of the Mental Capacity Act 2005 and acted in people’s best interests where people lacked capacity to consent. The majority of people accommodated had capacity to make their own decisions for all aspects of their lives. They were all consulted about and had given consent to their care and support.

The home was compliant with the Deprivation of Liberty Safeguards, with appropriate referrals being made to the local authority.

People were provided with a good standard of food, appropriate to their needs.

People and staff were very positive about the standards of care provided. People were treated compassionately as individuals, with staff knowing people’s needs.

People’s care needs had been thoroughly assessed and care plans put in place to inform staff of how to care for people. The plans were person centred and covered all areas of people’s needs. The plans we looked at in depth were up to date and accurate. It was agreed that for people with mental health needs, their care plans would be developed to further support these needs.

Staff and the manager took action when people’s needs changed or responding to newly assessed needs.

Some activities were arranged by members of the staff team.

There were complaint systems in place and people were aware of how to make a complaint.

Should people need to transfer to another service, systems were in place to make sure that important information would be passed on so that people could experience continuity of care.

The home was well led. There was a very positive, open culture in the home.

There were systems in place to audit and monitor the quality of service provided to people.

During our inspection we reviewed the records of ten staff and found their training was extensive and comprehensive. We spoke with four staff who told us their training was excellent and they felt well supported by the manager and deputy. In addition, they received regular supervision and annual appraisals. This meant staff were trained and supported to provide care and support that met people's needs.

There were 10 people living at Portelet House at the time of our inspection. We were unable to obtain their views because of their mental and physical frailty. We gathered evidence of people's experiences of the service by reviewing relevant records, observing how care staff interacted with people and talking with visitors.

We saw that care staff encouraged people to retain their skills and independence and provided them with the support they needed.

Visiting relatives and a healthcare professional we spoke with were complimentary about the care people received.

The provider had arrangements in place that ensured that the building and equipment used to provide specialist care and treatment people required was safe and properly maintained.

We saw that the provider's recruitment procedures ensured people's suitability to work with vulnerable adults was checked before they started work at the home.

Care staff we spoke with told us there were always enough of them on duty to meet people's needs. They said they received regular training about health and safety matters.

There were arrangements in place to monitor the quality of the service provided and to check that the provider's procedures were implemented properly.

We used a number of different methods to help us understand the experiences of people using the service. This was because they had complex needs which meant they were unable to tell us what it was like to live at Portelet House. For example we spent almost an hour watching and observing the help and support people received. We also spoke to the relatives of three people and telephoned a health care professional who regularly visited the home.

We looked at the records the home kept about five people including two of the people we observed and whose relatives we spoke with. We also spoke with three staff who were on duty at the time of our inspection visit. This was in order to see what they knew and understood about the care needs of the people whose records we looked at.

We noted that staff generally encouraged and supported people appropriately.

All the visiting relatives we spoke with told us they visited the home regularly. The relatives of two of the people living at the home expressed very positive views about the home and the care their relatives received. The third relative expressed several concerns.

A health care professional who visited the home frequently told us that they had no concerns about the home. They said that in their view people were well looked after. They told us the staff were observant and skilled at identifying problems that required their help.

We observed some of the day to day routines in the home and we were able to conclude from demeanour and behaviour of people living and working in Portelet House the nature and quality of the various interactions that we witnessed. We saw that relationships between staff and people living in the home were friendly, relaxed and informal. We staff helping and supporting individuals' in a number of different situations. These included, using hoists to transfer people from wheelchairs, helping people to eat at meal-times, supporting them to take medicines that they required and enabling them to participate in social activities. In all these situations we saw that staff were polite, sensitive, and when supporting people doing it in ways that promoted and respected their choices and promoted their dignity, privacy and independence.

Visiting relatives said that the care that Portelet House provided was 'fantastic', 'outstanding' and 'second to none' and that the staff were 'excellent'. They told us that they were involved in decisions about the care their relatives received and regularly sent questionnaires to obtain their views about the quality of care that the home provided.